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Psychiatrists challenge FDA panel on antidepressants in pregnancy

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Leading psychiatrists say a US panel promoted false claims about antidepressants in pregnancy, including that they are ineffective and linked to autism or birth defects.

The meeting on Monday featured 10 panellists, several of whom rejected the prevailing medical view on the safety of antidepressants during pregnancy.

They raised concerns about conditions such as autism, miscarriage and birth defects, and in some cases claimed depression resolves without treatment.

Three of the experts were based outside the US, while another runs a clinic that supports people stopping psychiatric medication.

Much of the discussion centred on selective serotonin reuptake inhibitors (SSRIs) such as Lexapro, Prozac and Zoloft, which boost serotonin levels in the brain to help improve mood.

Dr Joseph Goldberg is clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.

He said: “They were really rousing concerns about safety that are not evidence-based or established and not at all balanced with concerns about the risks of untreated depression.”

Goldberg, a past president of the American Society of Clinical Psychopharmacology who has previously consulted for pharmaceutical companies, said he was invited to join the FDA panel but declined because the invitation suggested it would not be a fair discussion.

Dr Jennifer Payne, director of the Reproductive Psychiatry Research Programme at the University of Virginia, said: “I’m disappointed that the FDA brought people in from outside of the United States when there’s so many experts here in the United States who truly know this [medical] literature inside and out.”

The general medical consensus is that continuing SSRIs during pregnancy is often safer than stopping, particularly because untreated depression can lead to thoughts of self-harm or low birth weight.

Babies may sometimes show temporary symptoms such as irritability or jitteriness after birth – known as neonatal adaptation syndrome – which typically pass quickly.

While some studies have suggested a slightly higher risk of miscarriage, there is no solid evidence linking SSRIs with autism or birth defects.

“Well-controlled studies continue to not find an association,” said Payne.

Women with a history of depression are also at risk of recurrence during pregnancy, which carries its own potential harms.

One panellist, David Healy – a fellow of the Royal College of Psychiatrists in the UK – claimed: “It’s been said that SSRIs help people who are severely depressed. They don’t.”

Goldberg called that statement “simply untrue”, adding: “You can say the moon landing was faked. Conspiracy theories abound in our world. But there is not a doubt about whether SSRIs work.”

Psychologist Roger McFillin, who hosts a podcast critical of mainstream psychiatry, suggested depression is not an illness but an intense emotional state, particularly in women.

He also claimed, without evidence, that many women are pressured into taking antidepressants during pregnancy.

“I have never, ever, ever, ever heard of a third party pushing a prescription in pregnancy,” Goldberg said.

He added that some obstetrician-gynaecologists unfamiliar with SSRIs have wrongly advised patients to stop taking them.

The American College of Obstetricians and Gynecologists described the panel as “alarmingly unbalanced”.

In a statement, it said: “On a panel of 10 experts, only one spoke to the importance of SSRIs in pregnancy as a critical tool, among others, in preventing the potentially devastating effects of anxiety and depression when left untreated during pregnancy.”

That panellist was Dr Kay Roussos-Ross, a psychiatrist and obstetrician-gynaecologist at the University of Florida College of Medicine, who repeatedly questioned the panel’s conclusions.

“All of us can find a study that agrees with exactly what we think,” Roussos-Ross told the panel.

“But we need to look at the data very objectively.”

An FDA spokesperson defended the panel, saying Commissioner Martin Makary “has an interest in ensuring policies reflect the latest gold standard science and protect public health” and calling criticism of the event “insulting to the independent scientists, clinicians, and researchers who dedicate their expertise to these panels.”

The event followed Health and Human Services Secretary Robert F. Kennedy Jr’s call for a review of antidepressant use.

His “Make America Healthy Again” report warned of “potentially major long-term repercussions” from childhood use of the medications.

Fertility

GLP-1 drugs do not increase pregnancy risks, study finds

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GLP-1 drugs taken before conception were not linked to higher pregnancy risks in new research, which suggested they may even offer some protection.

Women of reproductive age are increasingly prescribed GLP-1 drugs for weight-management support, but the risks and benefits of using them before pregnancy remain poorly understood.

The findings support continuing the use of GLP-1 medicines in women with metabolic risk factors who are considering pregnancy, said Cara Dolin, a maternal-fetal medicine specialist and co-author of the research, which was presented at the Society of Maternal-Fetal Medicine pregnancy meeting in February 2026.

“While there’s more research to be done, this data provides some reassurance that it is not harmful to be taking a GLP-1 if you’re planning a pregnancy, and that having done so may in fact benefit you by optimising your preconception metabolic health.”

The researchers examined electronic medical records for patients with a pre-pregnancy BMI of more than 30 who delivered at more than 20 weeks’ gestation. The data were reviewed for two studies: one assessed the link between pre-pregnancy GLP-1 use and the risk of gestational diabetes, while the second looked at the risk of severe maternal morbidity in patients with obesity.

Women with obesity, diabetes, cardiovascular disease and other cardiometabolic disorders have a higher risk of pregnancy complications including preeclampsia, gestational diabetes, stillbirth, caesarean section and other outcomes. While GLP-1 medicines can help manage these conditions, they are contraindicated during pregnancy, and women are typically advised to stop the medication two months before trying to conceive.

However, stopping the drugs can often lead to rebound weight gain or worsening metabolic health. A 2025 study suggested this rebound worsened some pregnancy outcomes, but the risks and benefits are still poorly understood, Dolin said.

“There is a lot we just don’t know, which is why we wanted to look at our experience here with our Cleveland Clinic patients and see whether taking GLP-1 drugs before pregnancy was causing harm or if it was beneficial and helping patients have healthier pregnancies.”

Researchers analysed data for more than 8,000 women who had obesity but did not have diabetes before they became pregnant. They compared outcomes for 208 women who had been prescribed GLP-1 receptor agonists before pregnancy with those who had not been prescribed the medication.

Women in the GLP-1 group had more risk factors heading into pregnancy. They tended to be older and have a higher body mass index, higher rates of bariatric surgery and chronic high blood pressure, and present earlier for prenatal care.

However, outcomes for the two groups were similar. Researchers found that the GLP-1 group did not have higher rates of gestational diabetes, severe maternal morbidity or other adverse maternal outcomes, suggesting that the medication may have helped mitigate elevated risk factors.

“I think this is a really important signal, and it may reflect that these patients were able to optimise their metabolic health prior to conception.”

“It shows there’s potential to use these drugs in a more targeted way with patients who are planning a pregnancy and have these different comorbidities and obesity.”

While the findings suggest that using GLP-1 drugs before pregnancy may be beneficial in women with metabolic risk factors, having a plan to stop the medicines before conception is essential, Dolin noted. In some cases, patients may be moved to an alternative medication that is safe for pregnancy and can be used to help manage their metabolic health during pregnancy.

Providers with patients who are taking GLP-1 medicines and planning a pregnancy should consider referral to a maternal-fetal medicine specialist for pre-pregnancy counselling.

“We can have a nuanced conversation with the patient about taking the medication, what the benefits are, what the potential risks are, and help them formulate a plan to transition off the medication once they’re ready to start trying to conceive,” she said.

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Early miscarriage care could prevent 10,000 pregnancy losses a year, study finds

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Early miscarriage care after a first loss could prevent about 10,000 pregnancy losses a year in the UK, according to a new study.

The study by Tommy’s National Centre for Miscarriage Research and Birmingham women’s hospital involving 406 women found a 4 per cent reduction in the risk of future miscarriage for women on the graded model of care compared with usual care.

Women in England, Wales and Northern Ireland currently become eligible for specialised NHS care for early baby loss only after they have had at least three miscarriages.

Tommy’s has called for women to become eligible after one miscarriage, saying this could reduce the risk of future miscarriages and improve health outcomes for mothers.

Researchers said that would translate to 10,075 fewer miscarriages a year across the UK.

Kath Abrahams, chief executive of Tommy’s, said women were being “left without early access to services that could help prevent future losses and reduce the debilitating feelings of isolation and hopelessness that we know affect so many who experience pregnancy loss”.

She said: “Our pilot study indicates that providing support after a first miscarriage, with escalating care after further losses, is not only effective but achievable without significant additional workload for NHS teams who are already working extremely hard to deliver good care.

“Put simply, it is the right thing to do. We will do all we can to drive that change across the UK so that more women and families are supported after every miscarriage.”

The graded model of miscarriage care proposed by Tommy’s is already available in Scotland, and the charity is calling for it to be introduced across the whole of the UK.

The graded model includes nurse-led support after one miscarriage, with advice on reducing risk factors such as low vitamin D, folic acid intake, alcohol consumption and caffeine use.

Women who received the specialised care were 47 per cent more likely to have a risk factor identified and receive relevant advice to help prevent future miscarriages than women receiving usual care, the study found.

Among women who had experienced two miscarriages and received the specialised care, one in five were found to have thyroid dysfunction or anaemia, both conditions that can affect pregnancy outcomes.

About one in four pregnancies ends in miscarriage, most often within the first 12 weeks of pregnancy.

The report comes ahead of the long-awaited final findings of the government’s investigation into maternity care in England. Interim findings uncovered a range of failures, including claims that NHS hospitals that caused harm to women and babies during childbirth often resorted to a “cover-up” of their mistakes, falsified medical records and denied bereaved parents answers.

Women’s health minister Gillian Merron said: “Pregnancy and baby loss can have a devastating impact on women and families, who too often feel they have been left without the care and support they need.

“I welcome the findings of this important report, and this will be carefully considered as part of our ongoing work to make sure women get the high-quality, compassionate NHS care they deserve.”

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Home blood pressure checks could lower heart risks for new mothers – study

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Home blood pressure checks after hypertensive pregnancy could cut the risk of heart attack, stroke and potentially early death, research suggests.

Women who regularly monitored their blood pressure in the weeks after giving birth, and had doctors tailor their medication if needed, had better functioning arteries nine months later than those who received routine care.

When the medication was adjusted to account for blood pressure changes, the women ended up with less stiff arteries, an effect researchers estimated could reduce the future risk of heart attack or stroke by 10 per cent.

Paul Leeson, professor of cardiovascular medicine who led the study, said the findings suggested that the weeks after birth provided a “powerful and often overlooked opportunity” to protect women’s future health.

“By simply monitoring blood pressure at home, new mothers with hypertensive pregnancies can protect their bodies from future damage,” he said.

High blood pressure, in the form of gestational hypertension or pre-eclampsia, where there are signs of organ damage, affects 5 to 10 per cent of pregnant women.

The condition can damage the mother’s organs and endanger the baby’s life.

Beyond the immediate threat to mother and baby, hypertension in pregnancy can raise the risk of long-term problems, with women three times more likely to develop high blood pressure and twice as likely to have heart disease later in life.

The Oxford team recruited 220 women who developed hypertension in pregnancy. All were on blood pressure medication but were due to reduce their dosage and eventually stop taking the drugs.

In the study, 108 women had standard care in which their medication was reduced based on a few blood pressure checks in the eight weeks after giving birth.

The remaining 112 women used a monitor to check their blood pressure at home each day.

They entered the readings into an app shared with doctors who, if needed, changed their medication day to day, with the aim of giving them better control of their blood pressure.

The new approach led to much better control of the women’s blood pressure, and in tests six to nine months later the women had less stiff arteries.

Stiff arteries are less effective at expanding and contracting, which can drive high blood pressure and ultimately the formation of clots that can block blood vessels and cause heart attacks and strokes.

Trials are now under way to find effective ways of rolling out blood pressure monitoring to women after hypertensive pregnancies. One option is for specialist NHS clinics to deliver the care.

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation, which funded the work, said the results highlighted a crucial window after birth when paying close attention to blood pressure could help protect women’s heart health for years to come.

“We now look forward to seeing results from larger studies with longer follow-up to see how this might save women’s lives,” she said.

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